March 08, 2006

North Carolina Patients discharged to homeless shelters

The Winston-Salem Journal reported this week that increasingly, North Carolina mental patients are being discharged to homeless shelters.

The paper noted:

"North Carolina treated and sent 1,140 mental-health patients such as Dobbins to homeless shelters in 2004, compared with 763 in 2000, according to state records.

Mental-health advocates accuse the state of having no consistent plan to care for thousands of homeless patients once they're discharged from a state hospital and leaving the responsibility to shelters that are ill-equipped to manage those patients.

Without such care, many patients are ending up back on the street, they say.

North Carolina health officials counter that state hospitals cannot keep patients after their mental evaluations are over and blame the rise in discharges on a lack of housing for low-income residents.

Still, critics say, the growing homeless numbers are another example of the cracks in North Carolina's mental-health care system. Without sufficient care, thousands of mentally ill homeless patients are simply being recycled in and out of the state's psychiatric hospitals, with few afforded off-ramps to stability.

"There's so much pressure to reduce bed use. Folks are being discharged in unstable conditions," said Marvin Swartz, the head of the psychiatry and behavioral sciences department at Duke University.

An investigation by the Winston-Salem Journal last year showed how the overhaul of the state's $2.3 billion mental-health system that began four years ago has failed to adequately provide services for the more than 358,000 North Carolina residents who have mental-health problems.